Coping with changes in the Defined Daily Dose in a longitudinal drug consumption database

Vlahović‐Palčevski, Vera; Gantumur, Monja; Radošević, Nives; Palčevski, Goran; Stichele, Robert Vander

doi:10.1007/s11096-010-9366-0

Cited by 41 publications

(27 citation statements)

References 4 publications

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“…However, additional reforms are needed to further improve ARB prescribing efficiency, especially when prescribing habits are ingrained. This mirrors the results from other studies where multiple demand side measures are needed to appreciably change utilisation patterns given the complexities of prescribing decisions [4,8,9,12,15,41,[46][47][48].…”

Section: Discussion and Future Implicationssupporting

confidence: 79%

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Influence of lifting prescribing restrictions for losartan on subsequent sartan utilization patterns in Austria: implications for other countries

Bucsics¹,

Godman²,

Burkhardt³

et al. 2012

Expert Review of Pharmacoeconomics & Outcomes Research

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Introduction: Prescribing restrictions for angiotensin receptor blockers (ARBs) limited their utilisation in Austria. Recently generic losartan became available with its prescribing restrictions lifted whilst still in place for patented ARBs. Objectives: Assess the impact of the lifting of the prescribing restriction on (a) utilisation of losartan in ambulatory care versus other single ARBs, (b) expenditure per DDD (defined daily dose) of losartan as well as total ARB expenditure, and (c) utilisation of ARB combinations. Lastly, suggest potential measures that could be introduced to further enhance ARB prescribing efficiency. Methodology: Quasi-experimental study of the utilisation of different ARBs alone or in fixed dose combinations (FDCs) using a segmented time series. Utilisation measured in DDDs, defined as 'the average maintenance dose of a drug when used in its major indication in adults'. Costs measured as total expenditure for different ARBs as well as their expenditure/ DDD. Results: Losartan utilisation increased significantly following the withdrawal of prescribing restrictions (P>0.001). Utilisation of patented ARBs also increased, but the growth rate was appreciably reduced once restrictions were lifted for losartan (P>0.01). As a result, total expenditure of single ARBs increased but at an appreciably lower rate than utilisation, helped by total expenditure/ DDD for losartan declining by 78% over the study period. There was continuing appreciable utilisation of FDCs. Conclusions: Lifting of prescribing restrictions for losartan significantly enhanced its utilisation, increasing ARB prescribing efficiency, providing direction to other European authorities. Additional reforms are needed to further switch utilisation from other ARBs to additionally improve prescribing efficiency. These are being considered as more ARBs lose their patents.

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Section: Discussion and Future Implicationssupporting

confidence: 79%

“…2011 DDDs were used in line with international guidance [8,9,41,106], with the WHO methodology used to calculate the DDDs for the combination products. This was based on the principle of counting the combination as one dose [12,22,106].…”

Section: Methodsmentioning

confidence: 99%

Influence of lifting prescribing restrictions for losartan on subsequent sartan utilization patterns in Austria: implications for other countries

Bucsics¹,

Godman²,

Burkhardt³

et al. 2012

Expert Review of Pharmacoeconomics & Outcomes Research

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“…This measure is recognised as the international standard to assess utilisation patterns within and between countries (42).Current DDDs were used in line with recommendations [42,43]. This is similar to the methodology employed to assess current dosing of statins in other studies [38,44].…”

Section: Methodsmentioning

confidence: 99%

Statin prescribing among hypertensive patients in southwest Nigeria: findings and implications for the future

et al. 2016

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This version is available at https://strathprints.strath.ac.uk/54803/ Strathprints is designed to allow users to access the research output of the University of Strathclyde. Unless otherwise explicitly stated on the manuscript, Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Please check the manuscript for details of any other licences that may have been applied. You may not engage in further distribution of the material for any profitmaking activities or any commercial gain. You may freely distribute both the url (https://strathprints.strath.ac.uk/) and the content of this paper for research or private study, educational, or not-for-profit purposes without prior permission or charge.Any correspondence concerning this service should be sent to the Strathprints administrator: strathprints@strath.ac.ukThe Strathprints institutional repository (https://strathprints.strath.ac.uk) is a digital archive of University of Strathclyde research outputs. It has been developed to disseminate open access research outputs, expose data about those outputs, and enable the management and persistent access to Strathclyde's intellectual output. Atorvastatin was the most prescribed statin, followed by simvastatin, rosuvastatin and finally fluvastatin. Prescribed doses were less than 1 defined daily dose in the majority, with high use of originators.

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“…• The 2010 defined daily doses (DDDs) have been used in line with international guidance [22][23][24]108], with the WHO methodology used to calculate the DDDs for the combination products. This was based on the principle of counting the combination as one dose [108].…”

Section: Country Key Supply-and Demand-side Reformsmentioning

confidence: 99%

Influence of demand-side measures to enhance renin–angiotensin prescribing efficiency in Europe: implications for the future

Vončina

Strizrep

Godman

et al. 2011

Expert Review of Pharmacoeconomics & Outcomes Research

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Coping with changes in the Defined Daily Dose in a longitudinal drug consumption database

Abstract: Drug consumption data should be calculated with the latest DDD value in the time window. The policy of the World Health Organisation to keep changes to the system of DDD to a minimum should be continued.

Cited by 41 publications

References 4 publications

Influence of lifting prescribing restrictions for losartan on subsequent sartan utilization patterns in Austria: implications for other countries

Influence of lifting prescribing restrictions for losartan on subsequent sartan utilization patterns in Austria: implications for other countries

Statin prescribing among hypertensive patients in southwest Nigeria: findings and implications for the future

Influence of demand-side measures to enhance renin–angiotensin prescribing efficiency in Europe: implications for the future

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